| NPI | 1467751743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA 034197) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 22608) |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2026-05-09 |